Just A Daughter

I’m really trying very hard not to feel like a complete idiot right now.

I attended another appointment with my parents today. It was a follow up with the physician that made a diagnosis last year of minimal cognitive impairment (MCI).  Since we were seen there last year there’s been some worsening of his memory and behavior and we were assessed by a different neurologist to rule out a structural brain disease called Normal Pressure Hydrocephalus. It was at that appointment a few weeks ago that the diagnosis of Alzheimer’s dementia was made.

At today’s appointment I sensed a bit of push back from the geriatrician as to why we were seen at a different clinic.  After explaining, I then asked her a few questions about disease progression and whether starting medication last year might have helped. I didn’t think I was being critical but when the physician turned to me and asked, “Well, you’ve read the literature, right?” I felt like she went on the defensive. I said I had, (and I had read about minimal cognitive impairment last year!) she asked me what I remembered.

Um, excuse me? This wasn’t a teaching moment. I’m not her resident. I’m asking as a daughter, not a physician.  I couldn’t believe she was treating me that way, and in front of my parents.  I don’t care if she was pissed off that we went to another hospital and got a diagnosis, she had no right to treat me like that.

I was honest and said I couldn’t recall. She then answered my question. 10-15% of patients with MCI progress. Sadly my father is one of them. And starting medication earlier would not have been indicated. In fact it could have made things worse. As she related the information to me it started to come back. Still, I felt stupid for not remembering it and even more stupid for asking the questions.  All I can see is my dad and his diagnosis. I should have the intellectual capacity to look clinically at the literature and apply it to my dad but you know, I can’t.

I’m just his daughter today.

I debriefed with my colleagues today and they agreed that it really wasn’t appropriate the way the specialist treated me. I have to get over my anger because this is the person who will be caring for my dad. I have to find a way to put it behind me. But right now, I can’t.



ut memores sitis eorum

Day 20. National Blog Posting Month.

A person’s memory is everything, really. Memory is identity. It’s you.


Another day.

Another doctor’s appointment with my dad. I got up at the crack of dawn just as the baby was waking up for his bottle. My dad’s appointment was at a downtown hospital early this morning so I had to hustle to get there on time.  They had already started with the nurse when I arrived.  She was just starting to get his history as I sat down on the exam room table.  Looking around it was your typical hospital office/exam room. I noted the clock on the wall and stared at it for a second, realizing it wasn’t working; I checked my phone to confirm the time.  Dad was busy talking away with the nurse.  My eyes kept returning to the clock; probably five minutes elapsed before I realized why I was drawn to the clock.


By this point the nurse was starting the memory testing with my dad so while I was trying to pay close attention to how he was doing and mentally trying to remember how to score the test as he did it, several minutes elapsed and I noticed something else about this clock.

It was very surreal.  I wish I could describe the thought processes my brain went through when it was trying to reconcile what I was seeing with what I know about how a clock should look and act.  When it all came together I almost laughed out loud but I restrained myself as at this point in the interview, my dad was asked to draw a face of a clock and put the hands of the clock on to show a specific time – 10 minutes after 11.

The clock drawing test is a brief but highly informative tool that physicians and psychologists use to test an individual’s executive functioning. It is a very easy test to administer and is part of the screening tests used to diagnose, or exclude, a diagnosis of dementia.   My heart skipped a beat when I watched my father do it.  He drew the circle, placed the numbers and the hands of the clock correctly, without missing a beat.  I’m pretty sure I breathed a sigh of relief when he was done.  In fact, most of his cognitive testing was normal, particularly in executive functioning, language and calculation skills. Where he failed was in memory and recall – pretty much exactly what we’ve noticed over the past year or so.

We were reassured in one respect that his issues right now are mild and that 90% of individuals with amnestic mild cognitive impairment remain stable over time.  Yet now as I am reading up on mild cognitive impairment, it is widely considered to be a precursor to Alzheimer’s dementia. I think it might be time to stop reading.  He’s going to be seen again next summer and I suppose we will just have to take the “wait and see” approach.  Right now there’s nothing we can do and for a doctor who is also a daughter, that’s probably the hardest thing in the world to be told.

A Mishmash.

Day 17. National Blog Posting Month.

I don’t know what this post is going to be about – I am just starting to write and will see where it takes me. Hold on, folks!!

Yesterday I went for my 3rd run.  The aim was 3km.  I tuck my phone in my pocket with the GPS running but the only voice prompts I get are the minutes elapsed, so I have no idea how far I’m going.  Based on my 2nd run which was 2.72 km, I went the same route initially, then a bit further in order to try to make 3 km.  My first interval was 3:1 (run/walk).  It felt good.  But then the shins started burning.  I was forced to scale back to 2:2 intervals.  By the time I made it home the burn was constant.  When I looked at my GPS tracker it said 2.9km.  Dammit!!  So close!!


I took the kids to visit their great-grandmother in the nursing home.  It was a very nice visit – the older two are always happy to go because they know they’re going to get treats (ie. little mint candies that my aunt leaves for my grandmother).  There’s also a vending machine there and the toddler just about loses his shit watching the mechanical arm catch the bottle of apple juice. It’s really quite funny.  My grandmother always has some gem to relate to me about the baby — his ears have to be covered or he’ll catch a cold; I shouldn’t carry him in such-and-such a way or it’ll stunt his growth.  I really have to bite my tongue with her, but she’s old and stubborn and has Alzheimer’s so I just let her talk.  I love seeing her with the kids though, she laughs and smiles. Sadly, I don’t remember her being that happy when I was growing up.


I think I mentioned previously that I waste a lot of time on Pinterest.  Mostly I browse through Geek, Health & Fitness, Quotes, and Humor.  Recently there’s been a few pins that I thought I’d share here, because they speak to me on many levels.


My daughter to her little brothers.

I’m not the pushover some people think I am.

I love how far we’ve come in such a short period of time.

You know who you are.

And last, but not least …


Getting Old

My 90-year old grandmother was recently moved to a long-term care facility.  She had been on a waiting list for close to 2 years when the room became available.  Prior to the move she was living on her own in an apartment building.  My mom and aunt would take her shopping for food and would help her bathe once a week, but up until about a year ago she was still cooking.

Now, this wouldn’t be a big deal except for the fact that my grandmother has early stages of dementia, or she did a few years ago.  Her disease has progressed in the last year.  Her MMSE (mini-mental status exam) scores have declined.  She scored 28/30 a year ago and 1 month ago her score was 21/30.

Let’s just that she was not impressed with being told she had to move.  In fact, she had forgotten all about it until the day my aunt took her to the home.  Those first few days were really hard, not only on my grandmother but on my aunt in particular.  See, my grandmother also has a vicious streak.  She always has. It’s never been directed towards me or my brother, mostly towards her two daughters (my mom and aunt).   I don’t know what kind of trauma she went through back in the Old Country, but something hardened that woman and she is not an easy person to relate to.  My brother and I learned that very quickly growing up.  She is a very religious woman and when we stopped going to church as kids she never failed to remind us that we were going to hell.  When I didn’t get married in a church, she refused to attend my wedding – a decision she later admitted to regretting.

The sad thing is that I don’t really have any heartwarming memories of being with my grandmother.  Well maybe that’s not true – I do remember her taking me as a child to the local beach, which was always fun. But honestly, that’s about it.  As I mentioned, my grandmother was never really harsh with me, but I witnessed a lot of antagonism between my parents and her growing up.  The relationship between my mom and her mother has always been difficult.  Thankfully, my children will have much fonder memories of their grandparents.

I noticed a significant change in my grandmother’s general demeanor after my first child was born.  It was so profound, it had me in tears.  Never had I seen her so loving, animated, delicate even.  It was astonishing.  Despite everything, I am grateful that my daughter will have some memories of her great-grandmother.  In fact, I think all of my children will remember her – she’s as strong as an ox.  Her memory may not be but her personality and overall general health will certainly make up for it.

Watching my aunt go through this ordeal has prompted my brother to have the discussion with our own parents.  When the time comes, we do not want to go through what my aunt went through.  We’ve made it clear that when it’s no longer safe for them to live independently, they will have to go to a retirement/long-term care facility.  Frankly, it sucks getting old.  Losing one’s independence has to be terrifying, never mind one’s memory.  Alzheimer’s disease has to be the most awful thing a child can witness in a parent.  Short term memory usually goes first, often the first symptoms are relatively mild.  But over time, the person can’t carry on a meaningful conversation anymore.  Confusion sets in, it’s almost like the person become child-like again, they have no memory of their life, of their children or grandchildren.   Heartbreaking, to say the least.

This past weekend, I took my daughter to visit her great-grandmother in her new home.  She looked the best I’ve seen her in a long time.  She’s eating much better and she seemed to really enjoy herself at the activities that were organized for the residents.  It was a good learning experience for my daughter as well.  Getting old is difficult, but it’s important she see that her great-grandmother is happy, safe, and well taken care of.